The health consequences of obesity include increased risk of heart disease, hypertension, diabetes, sleep apnea, cancer, osteoarthritis, and mental health problems. Postmenopausal women have reached an age when the incidence of chronic health conditions becomes more prevalent. In addition to physical disease risks, a lifetime of ridicule and disrespect may seriously and adversely affect general and health-related quality of life. Thus, obese postmenopausal women stand at a crossroads between living the remainder of their lives in essentially good health or facing the likely onset of chronic diseases that might have been prevented. This article reviews the effects of obesity that have particular relevance for postmenopausal women.